医联体模式下全膝关节置换术患者转诊康复效果的回顾性研究

摘要

目的 探讨医联体模式下全膝关节置换术(TKA)患者转诊康复的效果.方法 回顾性分析2016年1月—2017年1月,在北京市某三甲综合医院行TKA手术,术后早期转诊至医联体内两所康复医疗机构,接受康复治疗的190例研究对象的相关资料,包括一般资料、疾病及手术相关资料、转诊后康复相关指标以及实施医联体模式前后手术医院和康复医院TKA患者平均住院天数、相关费用变化情况.结果 经早期转诊康复治疗,研究对象在出院时术侧下肢的关节活动度、肌力等指标与入院时比较,差异有统计学意义(P<0.05).转诊后手术医院TKA患者总住院天数由(15.05±6.59)d缩短至(12.97±5.24)d,住院总费用降低2.18%,每膝费用降低4.76%,康复费用降低14.01%.结论 在医联体模式下,TKA患者术后早期转诊至医联体内康复机构,有利于患者康复,能够缩短手术医院住院天数,降低医疗费用,优化医疗资源配置.%Objective To explore the effects of referral and rehabilitation status of patients with total knee arthroplasty (TKA) under the mode of medical alliance.Methods One hundred and ninety cases with total knee arthroplasty in the secondary rehabilitation hospitals after referral from a tertiary hospital from January 2016 to January 2017 were analyzed, including general demographic data, disease and surgical data, rehabilitation data after referral, hospital day and change of medical expenses of the tertiary hospital and rehabilitation hospitals before and after the promotion of the medical alliance mode.Results After receiving the rehabilitation treatment in secondary rehabilitation hospitals, the range of motion, muscle strength and some other indices of the patients' surgical legs were significantly improved (P<0.05). And the hospital day of the surgical hospital was shorten from (15.05±6.59) d to (12.97±5.24) d, and medical expenses were decreased by 2.18% in total, 4.76% per knee and 14.01% in rehabilitation costs.Conclusions Under the mode of medical alliance, transferring patients with TKA from a tertiary hospital to secondary rehabilitation hospitals in their early postoperative phase can facilitate recovery of the patients, and it can also help to reduce hospital day and medical expenses, thus to optimize the allocation of medical resources.